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Electronic Eligibility
Most clinics today do not verify whether their patients are covered. Frontdesk staff typically will accept any insurance card because the card does not state a date of expiry. Eligibility can be verified by calling the payer directly which can take 5-15 minutes per patient. Some payers allow you to verify information through their website. But this is a tedious process to login to individual payer websites and enter in all the patient information.

What is the implication of not validating a patient? Once the patient completes the visit, the best case scenario is you that get a denial from the insurance. In that case your staff will need to contact the patient and get them to bring in the new insurance card. A very unsatisfactory experience for your patient. A more common scenario in this economic climate is that the patient is not covered. You will still need to contact the patient and then try to collect the money directly from the patient. The delay involved could run into months, each could take hours of staff time, add minimum overhead of $25 to your cost and still leave with unsatisfied patients.

alloFactor has integrated eligibility verification with alloFactor. alloFactor verification can be setup for batch or real time validation. With batch validation, system verifies all appointments the previous day. When the patient arrives, an icon immediately alerts the frontdesk staff to get the updated insurance card. Real-time eligibility verification is useful for walkins or new patients. At the click of a button, alloFactor contacts payer in real time and verifies the information and brings back eligibility information. A seamless experience for your staff with no additional effort on their part.

So what information do you get with eligibility verification? Most important is whether the patient is covered at the time of visit. You will also find out the patient demographic information including address, policy holder, date of birth. And most importantly the copay, coinsurance and deductible information. And why use alloFactor? First and foremost you get a world class practice management platform in alloFactor. Next alloFactor is tightly integrated with clearinghouses - which means you can submit a request and see results directly in alloFactor. Next alloFactor intelligently routes requests through multiple clearinghouses getting you the highest payer coverage. Finally alloFactor does not enforce any setup fee or mandate any minimum monthly fees.

Ready to setup eligibility verification? If you are new to alloFactor, download and setup your alloFactor practice management system. Next login to admin login and select the eligibility verification feature. We do the paperwork and usually within 24 hours you can start verifying eligibility.

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